Abstract
Katie Roiphe's book, The Violet Hour: Great Writers at the End, is a collection of writer portraits with dying and death as its axis. Her prologue lays out her premise, an exploration of the dying and death of five writers as revealed through their writing, their lifestyles, and accounts of those close to them. Each chapter can be read as a standalone study and is as diverse as the writers she chooses. Her inspiration, she explains, began with a severe childhood lung infection that almost took her life. This early experience gave birth to a preoccupation with death, unusual for a young adolescent, that has continued into adulthood. Her inquisitiveness compelled her to put pen to paper when her own beloved father died of a cardiac arrest at age almost 82 years. Roiphe's mission is to “avoid romanticizing, to look very closely at what is happening… without veering off into consolations or euphemisms or evasions or neat conclusions. Secretly, of course, one wants to learn how to avoid dying altogether (pp. 23–24).”
Roiphe is a professor and writer best known for her essays of cultural criticism and literary themes. Often they are informed by her own marriage and child-rearing experiences and shortcomings. Her prose in The Violet Hour is choppy, like a narrated dream, perhaps to reflect the phenomenon of time warping that illness and death invoke. As in her book of essays, In Praise of Messy Lives (The Dial Press, 2012), The Violet Hour does not shy away from turbulent or untidy topics. True to her literary leanings, the book's title refers to T.S. Eliot's poem “The Waste Land.”
At the violet hour, when the eyes and back
Turn upward from the desk, when the human engine waits
Like a taxi throbbing waiting,
I Tiresias, though blind, throbbing between two lives,
Old man with wrinkled female breasts, can see
At the violet hour, the evening hour that strives
Homeward, and brings the sailor home from sea,
The typist home at tea-times, clears her breakfast, lights
Her stove, and lays out food in tins.
Roiphe explores each of her subjects idiosyncratically, as their words, dying processes and circumstances, dictate. First is Susan Sontag, the writer, outspoken political activist, and cultural critic, known for her sometimes abrasive style. Next is Sigmund Freud, the neurologist, author and architect of psychoanalysis. Freud, diagnosed with an aggressive oral cancer, continued heavy smoking despite his physician's vigorous pleas that he quit. Next, she explores John Updike, the prolific and Pulitzer Prize-winning author, for whom death was a primary theme of many of his novels. Roiphe next explores Dylan Thomas, the Welsh poet, whose lifestyle of drinking, smoking, and sexual promiscuity was almost as noteworthy as his incomparable writings. Finally, Roiphe includes children's book author-illustrator Maurice Sendak, whose writing was informed by his family's exposure to the Holocaust, although it is cloaked as playful children's literature.
For some readers, The Violet Hour's subject matter and Roiphe's style of uncovering coarse and dismaying accounts may be off-putting. My own father, a well-read man who spent his career in finance, has become intrigued by the palliative care field. As my father ages and loses friends, he spends time contemplating his own mortality and experiencing our culture's uneasy relationship with death and dying. He has loved other books I have recommended: Gawande's Being Mortal, Kalanithi's When Breath Becomes Air, and Katy Butler's Knocking on Heaven's Door. These books speak of him through their storylines and their characters. Roiphe's book, however, he disliked. To him, the characters were not likeable—in his words: “The people that Roiphe chose to interview all seemed to have severe character flaws that burdened the caregivers and friends around them. I felt no empathy for them, no feelings for what they were going through.” He cited examples such as Dylan Thomas' binge drinking, Freud's insistence on continuing to smoke, and Sontag's utter refusal to accept her own mortality and her mistreatment of those closest to her.
My father's aversion to The Violet Hour underscores the importance of its joining the canon of contemporary books about death and dying. The myth that our lifelong individuality and eccentricities dissipate and coalesce around a singular, peaceful deathbed scene is a fallacy that Roiphe's The Violet Hour dispels. Dying and death are often not heroic, clean, beautiful, or resolved; the deaths of Roiphe's subjects reflect this reality.
Another example of a more disorderly yet exquisitely human death appeared in The New York Times Magazine in an article on Dr. B.J. Miller. In it, Jon Mooallem profiles Miller's patient and compatriot Randy Sloan, a 27-year-old man who died at the Zen Hospice in San Francisco under Miller's care. In Miller's words: “most people aren't having these transformative deathbed moments… And if you hold that out as a goal, they're just going to feel like they're failing.” (New York Times Magazine, January 3, 2017). These kinds of depictions of dying and death are not gussied up or sterilized. Humanity is on display and while they may come off as unsentimental, they show the unique grit and beauty of each person.
Palliative care is maturing. We no longer promise that symptoms can always be controlled, and palliative sedation is gaining acceptance as a moral, legal, and ethical (albeit imperfect) relief for those with refractory symptoms. Palliative Care Version 2.0 includes honestly documented depictions like those in Roiphe's book. Striving for the elusive “good death” is not often our goal in palliative care, but this notion still holds weight for many. Roiphe's book is a powerful corrective for these romantic myths that persist about death and dying and exemplifies a nuanced approach to the national conversation about end-of-life care that is already underway.